# Prenatal Cannabis Use and Motivation to Quit: What a New Study Found > **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637) > **Publisher:** CED Clinic (https://cedclinic.com) > **Canonical URL:** https://cedclinic.com/prenatal-cannabis-quit-motivation-study/ > **Published:** 2026-08-02T17:55:46-04:00 | **Last Modified / Clinically Audited:** 2026-09-27T22:01:29-04:00 > **Clinical Summary:** Prenatal cannabis use and motivation were associated in a 176-person study, but the secondary analysis cannot prove motivation caused reduced use. --- CED Clinical Relevance #100 Cannabis Science Full Report A newly indexed peer-reviewed secondary analysis examines cannabis-use motivation and repeated self-reported use during pregnancy. Its clinical relevance is substantial, but its observational analysis cannot establish that motivation or counseling caused reduced use. Clinical Insight | CED Clinic Among 176 pregnant adults enrolled in a randomized trial focused on sexual-health and substance-use risk, 62 reported cannabis use during pregnancy. In secondary analyses, several forms of motivation to avoid cannabis were associated with lower odds of use or fewer use days across pregnancy. The analysis supports clinical attention to motivation and nonjudgmental counseling, but it did not randomize participants by motivation and does not prove that a specific motivational intervention reduced prenatal cannabis use. PregnancyCannabis UseMotivationPrenatal CounselingObservational Analysis Audience Pregnant patients, families, obstetric clinicians, addiction specialists, and cannabis-science readers Primary Topic Motivation to avoid cannabis and self-reported cannabis use during pregnancy Source [Read the full source](https://pubmed.ncbi.nlm.nih.gov/42539348/) A July 21, 2026 peer-reviewed secondary analysis followed 176 pregnant adults enrolled in a broader randomized trial. Higher scores on several motivation measures were associated with less self-reported cannabis use, but the study does not establish that motivation or a specific intervention caused the difference. What This Study Teaches Us Motivation is measurable and may help identify how ready a pregnant patient is to reduce cannabis use. In this sample, different motivation dimensions were associated with lower odds of use or fewer use days, although the pattern was not identical across outcomes. Why This Matters Prenatal cannabis conversations can be difficult because stigma may suppress honest disclosure. A structured, nonpunitive discussion of goals, reasons for change, barriers, and support needs may be more clinically useful than a warning alone. Study Snapshot Study Type Secondary observational analysis of data from a randomized clinical trial Population 176 pregnant adults who screened positive for sexually transmitted infection risk behavior Cannabis Use 62 participants, or 35.2%, reported cannabis use during pregnancy Mean Age 30.2 years Follow-up Baseline, 2 months, and 6 months during pregnancy Motivation Measure Four Treatment Self-Regulation Questionnaire subscales Cannabis Measure Timeline follow-back for any use and number of use days Main Finding Several motivation dimensions were associated with lower odds of use or fewer average use days Key Limitation Motivation was not randomized, so association does not establish causation Journal [Women’s Health](https://cedclinic.com/cannabis-for-chronic-pelvic-pain-self-management/) Reports Electronic Publication July 21, 2026 PubMed Indexing August 1, 2026 Authors Parlier-Ahmad, Milleson, Sen, Chen, Countryman, Zlotnick, and Tzilos Wernette PMID / DOI 42539348 / 10.1177/26884844261471764 Clinical Bottom Line The study supports assessing motivation as part of respectful prenatal cannabis counseling. It does not prove that a technology-delivered intervention, motivational interviewing, or motivation itself caused cannabis reduction. What the Researchers Studied The authors used data from pregnant adults enrolled in a randomized trial of a technology-delivered brief motivational intervention addressing sexually transmitted infection risk behaviors, including substance use. This paper reports secondary analyses relating four motivation subscales to self-reported cannabis use at baseline, 2 months, and 6 months. What the Analysis Found Of 176 participants, 62 reported cannabis use during pregnancy. Higher autonomous, introjected, and amotivation scores were associated with lower odds of cannabis use after adjustment for age and marital status. Higher autonomous, introjected, and external regulation scores were associated with fewer average cannabis-use days. The differing pattern across subscales and outcomes argues for careful interpretation rather than a single simple motivation effect. Why This Is Association, Not Intervention Proof Participants were enrolled in a randomized trial, but this analysis did not randomize people to higher or lower motivation. Motivation may reflect other factors that also influence use, including symptoms, social support, perceived risk, access to care, or readiness to change. The abstract does not report a randomized between-group cannabis outcome for the motivational intervention. The analysis therefore cannot show that the intervention caused reduced cannabis use. A Nonjudgmental Clinical Reading Motivation measures may help clinicians understand whether change is driven by personal goals, internal pressure, external expectations, or uncertainty. Those distinctions can shape how a conversation is framed. Because stigma can discourage disclosure and care engagement, counseling should support honest reporting, shared planning, and evidence-based discussion of pregnancy-related risk without punishment or shame. What Better Evidence Would Add A stronger causal test would prespecify cannabis outcomes, compare randomized intervention groups, verify exposure with appropriate measures, and report retention, missing data, adherence, and adverse outcomes. Larger and more diverse samples could also test whether motivation predicts change similarly across clinical, socioeconomic, and cultural contexts. How Strong Is This Evidence? The paper is peer reviewed, identifier-verified, uses repeated follow-up, and analyzes a clinically important sample of 176 pregnant adults with established motivation and cannabis-use measures. Where This Paper Deserves Skepticism This is a secondary observational analysis within a trial, not a randomized test of the reported motivation associations. Cannabis use was self-reported, the cannabis-using subgroup was modest, adjustment was limited, and residual confounding is likely. What This Paper Does Not Show The study does not prove that motivation causes abstinence, demonstrate that the technology-delivered intervention reduced cannabis use, establish fetal or neonatal outcomes, compare cannabis products or doses, or justify punitive screening practices. How This Fits With the Broader Clinical Conversation Pregnancy-related cannabis use can involve nausea, pain, sleep, anxiety, dependence, access barriers, and fear of judgment. A useful assessment needs to distinguish these contexts rather than treating every report of use as the same problem. Professional guidance generally recommends avoiding cannabis during pregnancy because safety has not been established and observational evidence raises concern, while also emphasizing counseling and treatment access rather than stigma. Dr. Caplan’s Take *The most useful feature of this study is its focus on why a person might want to change, not merely whether cannabis use is present.* *Motivation can inform the conversation, but it should not be mistaken for a causal treatment mechanism. Patients need clear evidence, practical alternatives for symptoms, and support that keeps them engaged in care.* What a Careful Reader Should Take Away Ask about cannabis use, reasons for use, readiness to change, barriers, and support needs. Treat motivation as clinical context, not as proof that a particular intervention will work. Evidence Interpretation Guide Table of Contents - [How to Read a Motivation Association During Pregnancy](#How_to_Read_a_Motivation_Association_During_Pregnancy)[A Four-Step Reading Frame](#A_Four-Step_Reading_Frame) - [The Same Study Can Mean Different Things Depending on the Question Being Asked](#The_Same_Study_Can_Mean_Different_Things_Depending_on_the_Question_Being_Asked)[Honest Context Helps](#Honest_Context_Helps) - [Assess Reasons and Readiness](#Assess_Reasons_and_Readiness) - [Trial Enrollment Does Not Make This Result Randomized](#Trial_Enrollment_Does_Not_Make_This_Result_Randomized) - [Self-Report and Sample Size Matter](#Self-Report_and_Sample_Size_Matter) - [Motivation Fits a Broader Counseling Literature](#Motivation_Fits_a_Broader_Counseling_Literature) - [Address the Reason for Use](#Address_the_Reason_for_Use) - [Test Interventions Directly](#Test_Interventions_Directly) - [Avoid Stigma and Surveillance Harm](#Avoid_Stigma_and_Surveillance_Harm) - [Frequently Asked Questions](#Frequently_Asked_Questions)[Related](#Related) ## How to Read a Motivation Association During Pregnancy The paper links measured motivation with repeated self-reported cannabis use. Four checks keep the result within its design. ### A Four-Step Reading Frame **Identify the analysis**This is a secondary observational analysis using participants from a randomized trial. **Separate motivation from assignment**Participants were not randomized to motivation levels, so measured motivation may travel with other determinants of use. **Read each outcome separately**The motivation subscales associated with any use were not identical to those associated with number of use days. **Keep clinical goals practical**The result supports individualized, nonjudgmental assessment but does not validate one intervention as effective. The Research Question Were different types of motivation associated with cannabis use and use frequency during pregnancy? The Patient Question How can my clinician help if I want to reduce or stop cannabis during pregnancy? The Bottom Line Motivation can guide counseling, but causal treatment claims require randomized outcome evidence. CED Perspective Lens ## The Same Study Can Mean Different Things Depending on the Question Being Asked Scientific papers rarely answer a single question. Patients, clinicians, researchers, policymakers, and critics often read the same data differently. The perspectives below explore how this study looks through several evidence-based lenses. Lens Overview Eight perspectives translate the motivation findings while protecting patients from causal overstatement and stigma. #### Honest Context Helps Tell your clinician what you use, how often, and why. A supportive plan can address symptoms, dependence, and practical barriers together. Lens takeaway Disclosure should open care, not punishment. #### Assess Reasons and Readiness Ask what cannabis is doing for the patient and what makes change easier or harder. Offer evidence-based alternatives and follow-up rather than relying on a warning alone. Lens takeaway Motivation is one part of a complete assessment. #### Trial Enrollment Does Not Make This Result Randomized The parent study was randomized, but the reported motivation associations were not. Residual confounding and reverse direction remain plausible. Lens takeaway The finding is associational. #### Self-Report and Sample Size Matter Cannabis use was assessed by timeline follow-back. Stigma, recall, subgroup size, and limited covariate adjustment may affect estimates. Lens takeaway Precision does not eliminate measurement limits. #### Motivation Fits a Broader Counseling Literature Readiness and self-determined reasons for change are established behavioral concepts. This paper applies them to prenatal cannabis use but does not establish a new treatment effect. Lens takeaway Conceptual relevance exceeds causal certainty. #### Address the Reason for Use Nausea, sleep, pain, anxiety, and withdrawal may require different supports. A reduction plan is more credible when it includes symptom alternatives and follow-up. Lens takeaway Match support to the patient’s actual barrier. #### Test Interventions Directly Future trials should prespecify cannabis outcomes and report randomized group contrasts. Biological verification and broader recruitment could strengthen inference. Lens takeaway Randomized outcomes are the next evidence step. #### Avoid Stigma and Surveillance Harm The cannabis-using participants differed on age, race, and socioeconomic status. Care systems should avoid turning those differences into biased assumptions or punitive responses. Lens takeaway Equitable counseling requires trust and consistent standards. Join the Conversation Have a question about how this applies to your situation? [Ask Dr. Caplan](https://benjamincaplan.com/ask-dr-caplan) Want to discuss this topic with other patients and caregivers? 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[Review the evidence context](https://cedclinic.com/medical-cannabis-during-pregnancy-and-breastfeeding-is-the-concern-fully-evidence-based/) [Arkansas Pregnancy Cannabis Study Shows Persistent Medical Purchases Across Trimesters](https://cedclinic.com/arkansas-medical-cannabis-pregnancy-study/) Related observational evidence on cannabis purchasing patterns during pregnancy and the need for specific counseling. [Compare the pregnancy data](https://cedclinic.com/arkansas-medical-cannabis-pregnancy-study/) [Ohio Launches Cannabis and Pregnancy Education Campaign](https://cedclinic.com/ohio-cannabis-pregnancy-education-campaign/) Clinical context for nonjudgmental pregnancy education and patient-clinician discussion. 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[Compare earlier coverage](https://cedclinic.com/ohio-cannabis-pregnancy-education-campaign/) ## Frequently Asked Questions Did this study prove that motivation causes less cannabis use during pregnancy? No. Motivation and cannabis use were associated, but motivation was not randomized and the analysis cannot establish causation. How many participants were included? The secondary analysis included 176 pregnant adults, of whom 62 reported cannabis use during pregnancy. Was this a randomized cannabis-cessation trial? Participants came from a randomized trial addressing sexual-health and substance-use risk, but this paper reports observational associations between motivation measures and cannabis outcomes. How was cannabis use measured? The study used timeline follow-back reports at baseline, 2 months, and 6 months during pregnancy. What kinds of motivation were assessed? The Treatment Self-Regulation Questionnaire measured autonomous, introjected, external, and amotivation dimensions related to not using cannabis. Did every motivation dimension show the same result? No. The subscales associated with any cannabis use were not identical to those associated with average number of use days. Does the study report infant outcomes? No. The reported analysis focused on motivation and maternal self-reported cannabis use, not fetal or neonatal outcomes. What is the main limitation? The secondary observational design cannot determine whether motivation caused lower use or whether other factors explain the association. What should a prenatal cannabis discussion include? It should include reasons for use, products and frequency, symptoms, readiness to change, dependence features, evidence-based alternatives, and a supportive follow-up plan. What is the practical takeaway? Assess motivation respectfully and use it to individualize support, while avoiding claims that this study proved a particular intervention works. ### Related --- ### Verification & Medical Governance - **Lead Clinical Author:** Benjamin Caplan, MD - **Credentials:** Board Certified in Family Medicine (ABFM), Founder & CMO CED Clinic & CED Foundation, Author of *The Doctor-Approved Cannabis Handbook* (Penguin Random House). - **Clinical Scale:** 350,000+ lifetime evaluations overseen; 81,008-patient Real-World Evidence Registry (`~/.ced_rwe_vault.db`); 125,000+ peer-reviewed study literature observatory (`http://localhost:8768/api/explorer/terminal`). - **License Verification:** Commonwealth of Massachusetts License #240562 (https://checkahealthlicense.mass.gov/). - **NPI Registry:** 1962722637 (https://npiregistry.cms.hhs.gov/provider-view/1962722637). - **Ethics & Data Privacy:** Clinical registry observations adhere strictly to HIPAA Safe Harbor de-identification (45 CFR § 164.514(b)) and criteria for secondary research exemption under 45 CFR § 46.104(d)(4).